UNDERSTANDING

RECOVERY
Presented By:
Rey J. Millena, MD, MCHM, FPCAM
CONTENT OF PRESENTATION
 STAGES OF CHANGE
 ECOLOGY OF
RECOVERY
COMPLEX
and DYNAMIC

PROCESS
“Recovery from alcohol and drug problems is a
PROCESS OF CHANGE through which an
individual achieves ABSTINENCE and
IMPROVED HEALTH, WELLNESS and
QUALITY OF LIFE.”

- Substance Abuse and Mental Health Administration

(SAMHSA) -
 “Recovery from the disease of drug
addiction is often a l o n g – t e r m
process, involving MULTIPLE RELAPSES
before a patient achieves prolonged
abstinence.”

- National Institute for Drug Abuse (NIDA) -

STAGES OF CHANGE
 STAGES OF CHANGE
 It is important to discuss HOW CHANGE HAPPENS before
explaining each step to promote change.

 Prochaska (1983), discovered that PEOPLE GO THROUGH SIX

STAGES OF CHANGE when they try to break unhealthy habits.

 DIFFERENT TASKS NEED TO BE ADDRESSED AT EACH STAGE

IN ORDER TO PROGRESS TO THE NEXT STAGE.

 It is IMPORTANT FOR THE CLIENT TO KNOW WHAT STAGE

THEY ARE IN. Without knowing this, the client might set goals
that are unrealistic.
PEOPLE PASS THROUGH A SERIES OF STAGES WHEN
CHANGE OCCURS:

1PRECONTEMPLATION 3
PREPARATION

5 MAINTENANCE
2
CONTEMPLATION
4 ACTION

WHAT STAGE AM I ON?

PRE-CONTEMPLATION
The individual is NOT
currently considering change:
DO NOT INTEND TO TAKE
ACTION IN THE NEXT SIX
MONTHS

They may be in “DENIAL”

about their problem or not
considering it seriously

"IGNORANCE IS BLISS“
 Being UNINFORMED OR UNDER
INFORMED about the
CONSEQUENCES of one’s behavior
may cause a person to be in this
stage
 Multiple unsuccessful attempts to
change can lead to
DEMORALIZATION ABOUT THE
ABILITY TO CHANGE
 DENIAL & IGNORANCE OF PROBLEM
 Precontemplators are often
characterized as RESISTANT,
UNMOTIVATED, OR UNREADY FOR
HELP.
STRATEGIES
Establish rapport and offer
support for any positive
change
Education on RISK VS
BENEFITS and positive
outcome related to change
Encourage re-evaluation of
current behavior
Encourage SELF-
EXPLORATION NOT ACTION
 CONTEMPLATION
 Begin to weigh the
ADVANTAGES AND
DISADVANTAGES of change

 PROBLEM
ACKNOWLEDGEMENT

The individual is INTENDING

TO TAKE ACTION IN THE NEXT
6 MONTHS
“THINKING OF CHANGING”
AMBIVALENT and
UNDECIDED about
changing
DESIRE TO CHANGE
exists but is RESISTANT
TO CHANGE
CONFLICTED EMOTIONS
 STRATEGIES
 Encourage
ambivalence through
client education
 Help them to see both
the PROS and CONS of
substance use and
change to move
towards a decision
 PREPARATION
Beginning to make a PLAN
FOR CHANGE
They are figuring out ways
to make sure goals are
achieved
Some experience with
change and are trying to
change: "Testing the waters"
Planning to act WITHIN
1MONTH
“READY TO CHANGE”
 INCREASING
CONFIDENCE in the
DECISION TO CHANGE
READY TO TAKE
THE FIRST STEP
Experimenting with small changes
Collecting information about change
Make final adjustment before they begin to
change their behavior
STRATEGIES
 Encourage the person
to WORK TOWARDS
HIS GOAL
 Develop realistic goals
 Provide positive
reinforcement
ACTION  The ACTIVE
WORK toward
desired behavioral
change including
modification of
environment,
experiences, or
behavior have been
taken.
“MAKING CHANGE”
 Have made overt
lifestyle changes in
the past 6 months.
Overt modification of
behavior & surroundings

COMMITMENT TO
CHANGE IS STILL
UNSTABLE
STRATEGIES
 ENCOURAGE the
person to continue
providing education
to reinforce
decision to stop
substance abuse
 PROVIDE POSITIVE
REINFORCEMENT
 MAINTENANCE
 PLAN INTO ACTION FOR
AT LEAST SIX MONTHS.

 The LESS TEMPTED TO

RELAPSE and
INCREASINGLY MORE
CONFIDENT that they can
continue their change
“STAYING ON TRACK”
IT IS STILL EASY TO FALL BACK INTO OLD
WAYS IF THEY STOP PAYING ATTENTION TO
THEIR PROGRESS

Focus is on ongoing, active work to maintain

changes made and relapse prevention

Take steps to prevent relapse

Gains have been consolidated

STRATEGIES
 Goal is RELAPSE
PREVENTION:
How to prepare
for difficult times
& places and
never to give up
 5

4
3
2
1
 RELAPSE AND RECYCLE
 It is a form of regression to
previous stages

 It refers to falling back to the

old behaviors after going
through other stages

 Regression occurs when

“FALL FROM GRACE” individuals revert to an
earlier stage of change.
 Evaluate TRIGGER for
RELAPSE
 RE-ASSESS WHAT STAGE
OF CHANGE HE/SHE
REGRESS
 Encourage and motivate
them according to what
stage they are in
 Plan stronger coping
strategies
 I ON
T
U CA
E D

DEVELOP
P SE DISCREPANCY
A
REL NTION
R EVE
P

OPTION MENU
 URIE BRONFENBRENNER’S
ECOLOGICAL SYSTEMS
 This theory views an individual’s
development within the context
of the system of relationships
that form her/his environment
 He believe that a person’s
development was affected by
everything in their surrounding
environment
 Human development is
influenced by the different types
of environmental system
 2

1
3
5
CHRONOSYSTEM 4
MICROSYSTEM
The immediate physical,
family, social, and cultural
environments that can act to
inhibit or support addiction
problem resolution.

***The microsystem exerts the most

direct influence—one’s family and
kinship network, intimate and social
relationships, the neighborhood, and the
workplace that constitute one’s stage of
daily living.
Thank you!!
